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Concern over increased rate of caesarean sections

By Kizito Lubano | July 13th 2016

Caesarean section is today considered the most common major surgical procedure performed in the world.

Sometime back, the World Health Organisation had established there was no valid justification to perform a caesarean section in more than 10 to 15 per cent of the cases.

However, in the last few years, this guidance has changed thus allowing greater flexibility and with it comes a much higher number of caesarean sections being performed.

Until recently, caesarean section rates were at a maximum of 25 per cent in public referral hospitals but in less than two years, these rates have increased by more that 100 per cent and now stand at 50 to 60 per cent.

In private practise, these procedures make up for 70 per cent of all deliveries.

In truth, the caesarean section has some medical advantages over vaginal delivery and saves lives where the reason is clear.

However, it does still pose some short and long term health risks to the mother and infant.

These procedures are also associated with an increase in morbidity and mortality of mothers and children. The other disadvantage is that it is costly to perform and therefore takes a huge chunk of public health resources.

Although there are studies that attempt to explain the significant clinical and economical increase in caesarean section, we still lack sufficient demographic studies that allow us to accurately define the factors that are contributing to its increase in Kenya.

Changes in diet, population density, exercise and reproductive behaviour mean that first-time pregnant women are commonly shorter, older and fatter than is ideal for first childbirth.

There is widespread perception that the increasing caesarean section rate is driven by obstetricians. This is only partly true, and critics should acknowledge the strong relevance of age and obesity, and the positive aspects of the operation.

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